慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停综合征患者血清Caspase-3和Caspase-9水平与认知功能障碍的相关性研究

Correlation of serum Caspase-3 and Caspase-9 levels with cognitive dysfunction in patients of chronic obstructive pulmonary disease complicated with OSAHS

摘要:

目的  探讨慢性阻塞性肺疾病（以下简称慢阻肺）合并阻塞性睡眠呼吸暂停综合征（OSAHS）患者血清Caspase-3和Caspase-9水平与认知功能障碍的相关性。方法  选取慢阻肺合并OSAHS患者312例，所有患者应用蒙特利尔（MoCA）量表进行认知领域评估，同时检测血清半胱氨酸天冬酶-3（Caspase-3）和半胱氨酸天冬酶-9（Caspase-9），探讨MoCA得分与血清Caspase-3、Caspase-9水平的相关性，以及血清Caspase-3和Caspase-9水平预测认知障碍的受试者工作特征曲线（ROC）。结果  血清Caspase-3、Caspase-9水平与MoCA评分呈负相关，血清Caspase-3水平预测认知功能障碍的ROC曲线，ROC曲线下面积为0.771（95%CI：0.689，0.852），Caspase-3为10.61ng/L时约登指数最大，其敏感性和特异性分别为0.653和0.938。Caspase-9水平预测认知功能障碍的ROC曲线，ROC曲线下面积为0.768（95%CI：0.687，0.849），差异有统计学意义（P <
0.05）， Caspase-9水平为11.19 ng/L时约登指数最大，其敏感性和特异性分别为0.642和0.938。结论  血清Caspase-3和Caspase-9水平的变化与慢阻肺合并OSAHS患者认知障碍的发生有关；在对认知障碍评估意义方面，血清Caspase-3和Caspase-9水平可以预测认知功能损伤，血清Caspase-3略优于Caspase-9。

Abstract:

Objective To investigate the correlation of serum Caspase-3 and Caspase-9 levels with cognitive dysfunction in patients of chronic obstructive pulmonary disease (COPD) complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods A total of 312 cases of COPD complicated with OSAHS patients were enrolled into the study. Montreal (MoCA) scale was used to assess cognitive function. Serum Caspase-3 and Caspase-9 levels were detected. The correlations of serum Caspase-3 and Caspase-9 levels with MoCA score were investigated. ROC curves of serum Caspase-3 and Caspase-9 levels in prediction of cognitive dysfunction were analyzed. Results Serum Caspase-3 and Caspase-9 levels had negative correlations with MoCA scores. The area under ROC curve (AUC) of serum Caspase-3 level to predict cognitive dysfunction was 0.771 (95% CI: 0.689, 0.852; P < 0.05); Youden index was the biggest when the Caspase-3 level was 10.61 ng/L, the sensitivity and specificity were 0.653 and 0.938 respectively. The AUC of serum Caspase-9 level to predict cognitive dysfunction was 0.768 (95% CI: 0.687, 0.849; P < 0.05). At the biggest Youden index, the Caspase-9 level was 11.19 ng/L, the sensitivity and specificity were 0.642 and 0.938 respectively. Conclusions Serum Caspase-3 and Caspase-9 levels have negative correlations with cognitive impairment in patients of COPD complicated with OSAHS. Serum Caspase-9 and Caspase-3 levels can predict the cognitive impairment, and Caspase-3 is superior to Caspase-9.